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Verburg L, Gabriel V, McCaffrey G. The impact of burn injuries on indigenous populations: A literature review. Burns 2024; 50:1355-1371. [PMID: 38570250 DOI: 10.1016/j.burns.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/31/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Ethnic minorities experience disparities in prevention and treatment of burn injury. Research focused on burn injuries in Indigenous populations is limited. This review summarizes literature on burn injuries in Indigenous populations to be considered to inform new research. METHODS A search was conducted in CINAHL, Ovid MEDLINE, PSYCinfo and SocINDEX. for "burn OR scars OR scald OR deformity OR disfigurement" and "Aboriginal OR Indigenous OR First Nation OR American Indian OR Maori OR Native OR Torres Strait Islander OR Amerindian OR Inuit OR Metis OR Pacific Islander". Inclusion 1) peer reviewed studies of burns in Indigenous persons 2) in English. Exclusion 1) no data specific to Indigenous burns 2) not peer reviewed 3) not in full text 4) protocol publications. RESULTS The search identified 1091 studies with 51 for review. Sixteen were excluded. The 35 included publications were published between 1987 and 2022. Findings indicated higher incidence of injury and poorer outcomes amongst Indigenous people. Indigenous people suffered more flame and inhalation burns, had longer lengths of stay, and more complications including hypertrophic scarring. Australian Indigenous patients struggle with a lack of culturally safe communication and support for aftercare. CONCLUSION Racial disparities exist in burn injury incidence and outcome for Indigenous persons. Qualitative research in this area will help providers better understand the experiences of Indigenous burn patients to develop more culturally competent care. We are currently developing a study using qualitative hermeneutic methodology to learn about the experiences of Indigenous burn survivors' injuries, recovery, and social reintegration.
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Affiliation(s)
- Leah Verburg
- Faculty of Nursing, University of Calgary, Canada.
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2
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Lee SP, Maluotoga M, Thind R, Lindsay L, Bhatta T, Miller CA. Utilization and Perception of Peer-Support After Lower Limb Loss in the United States: Potential Benefits on Mobility Outcomes. Arch Phys Med Rehabil 2024; 105:939-946.e3. [PMID: 38242299 PMCID: PMC11069449 DOI: 10.1016/j.apmr.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/30/2023] [Accepted: 12/14/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To examine participants' experiences with peer-support after lower limb loss (LLL) and the associations between the peer-support experience (perceived benefits and barriers) and mobility outcomes. DESIGN Quantitative and qualitative descriptive study with a cross-sectional design. SETTING National survey (distributed to 169 peer-support groups in 44 states in the US). PARTICIPANTS The survey was completed by 82 individuals with a major lower limb amputation (53% female, 54% over 55 years of age; N=82). MAIN OUTCOME MEASURES A 32-item survey to examine respondents' experiences in peer-support activities. Prosthetic mobility was measured using the Prosthetic Limb Users Survey of Mobility (PLUS-M). RESULTS Two out of 3 respondents received some forms of peer-support after amputation. Among them 75% reported peer-support having a positive effect on their outlook on life, and 78% reported that information gained from peer-support was helpful. Companionship, altruistic acts, and gaining information on how to cope with amputation were the top themes of why respondents enjoyed the peer-support experience. Nearly all (94%) respondents would recommend peer-support to other people with LLL. Individuals who received peer-support exhibited a trend of greater mobility (55th vs 36th percentile on PLUS-M; P=.055). CONCLUSION Individuals with LLL reported generally positive experiences regarding their engagement in peer-support activities. Peer-support groups are viewed as a helpful source for both information and emotional support, potentially benefiting functional and psychological recovery after amputation. Individuals who have received peer-support also exhibited greater mobility.
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Affiliation(s)
- Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV.
| | - Moriah Maluotoga
- Department of Physical Therapy, University of Nevada, Las Vegas, NV
| | - Roopkiran Thind
- Department of Physical Therapy, University of Nevada, Las Vegas, NV
| | | | - Tirth Bhatta
- Department of Sociology, University of Nevada, Las Vegas, NV
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3
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Jhunjhunwala R, Jayaram A, Mita C, Davies J, Chu K. Community support for injured patients: A scoping review and narrative synthesis. PLoS One 2024; 19:e0289861. [PMID: 38300931 PMCID: PMC10833531 DOI: 10.1371/journal.pone.0289861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Community-based peer support (CBPS) groups have been effective in facilitating access to and retention in the healthcare system for patients with HIV/AIDS, cancer, diabetes, and other communicable and non-communicable diseases. Given the high incidence of morbidity that results from traumatic injuries, and the barriers to reaching and accessing care for injured patients, community-based support groups may prove to be similarly effective in this population. OBJECTIVES The objective of this review is to identify the extent and impact of CBPS for injured patients. ELIGIBILITY We included primary research on studies that evaluated peer-support groups that were solely based in the community. Hospital-based or healthcare-professional led groups were excluded. EVIDENCE Sources were identified from a systematic search of Medline / PubMed, CINAHL, and Web of Science Core Collection. CHARTING METHODS We utilized a narrative synthesis approach to data analysis. RESULTS 4,989 references were retrieved; 25 were included in final data extraction. There was a variety of methodologies represented and the groups included patients with spinal cord injury (N = 2), traumatic brain or head injury (N = 7), burns (N = 4), intimate partner violence (IPV) (N = 5), mixed injuries (N = 5), torture (N = 1), and brachial plexus injury (N = 1). Multiple benefits were reported by support group participants; categorized as social, emotional, logistical, or educational benefits. CONCLUSIONS Community-based peer support groups can provide education, community, and may have implications for retention in care for injured patients.
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Affiliation(s)
- Rashi Jhunjhunwala
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Anusha Jayaram
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Justine Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kathryn Chu
- Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Deng H, Genovese TJ, Schneider JC. A Narrative Review of Outcomes in Burn Rehabilitation Based on the International Classification of Functioning, Disability, and Health. Phys Med Rehabil Clin N Am 2023; 34:867-881. [PMID: 37806703 PMCID: PMC10560762 DOI: 10.1016/j.pmr.2023.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Burn injury commonly causes long-term physical impairments and psychosocial limitations that impact survivorship. This article uses the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) framework to summarize burn rehabilitation outcomes related to body functions and structures and how they relate to activities and participation within the social context. This article will contribute to a better understanding of burn recovery, facilitate the identification of specific and meaningful issues common to burn survivorship that may be under-reported in prior investigations and guide future rehabilitation to advance long-term burn outcomes.
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Affiliation(s)
- Huan Deng
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA
| | - Timothy J Genovese
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, 300 1st Avenue, Boston, MA 02129, USA; Rehabilitation Outcomes Center at Spaulding, Boston, MA, USA; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Ryan CM, Shapiro GD, Rencken CA, Griggs C, Jeng JC, Hickerson WL, Marino M, Goverman J, Kazis LE, Schneider JC. The Impact of Burn Size on Community Participation: A Life Impact Burn Recovery Evaluation (LIBRE) Study. Ann Surg 2022; 276:1056-1062. [PMID: 33351466 PMCID: PMC8265012 DOI: 10.1097/sla.0000000000004703] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the association of burn size and community participation as measured by the LIBRE Profile. SUMMARY OF BACKGROUND DATA Burn size is an established clinical predictor of survival after burn injury. It is often a factor in guiding decisions surrounding early medical interventions; however, literature is inconclusive on its relationship to quality of life outcomes. METHODS This is a secondary data analysis of a cross-sectional survey of adult burn survivors. Self-reported data were collected between October 2014 and December 2015 from 601 burn survivors aged ≥18 years with ≥5% total body surface area (TBSA) or burns to critical areas. Sociodemographic characteristics were compared between participants with small burns (≤40% TBSA burned) and large burns (>40% TBSA burned). Ordinary least squares regression models examined associations between burn size and LIBRE Profile scale scores with adjustments for sex, current work status, burns to critical areas, and time since burn injury. RESULTS The analytic sample comprised 562 participants with data available for burn size. 42% of respondents had large burns (>40% TBSA burned) and 58% reported smaller burns (TBSA ≤40%). In adjusted regression models, patients with large burns tended to score lower on the Social Activities and Work & Employment scales ( P < 0.05) and higher on the Family & Friends scale ( P < 0.05). Participants with burns >40% TBSA scored lower for several individual items in the Social Activities scale and one item in the Work & Employment scale ( P < 0.05). CONCLUSIONS Increasing burn size was found to be negatively associated with selected items of Work & Employment and Social Activities, but positively associated with aspects of Family & Friend Relationships. Future longitudinal studies are necessary to assess and understand the long-term social impact of burn injuries on adult populations.
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Affiliation(s)
- Colleen M. Ryan
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Shriners Hospitals for Children – Boston, Boston, MA
- Harvard Medical School, Boston, MA
| | - Gabriel D. Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | | | - Cornelia Griggs
- New York Presbyterian/Morgan Stanley Children’s Hospital Department of Pediatric Radiology and Surgery, New York, NY, USA
| | - James C. Jeng
- Nathan Speare Regional Burn Treatment Center, Crozer-Chester Medical Center, Upland, PA
| | | | - Molly Marino
- Quality Measurement and Health Policy Program, RTI International, Waltham, MA
| | - Jeremy Goverman
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA
- Spaulding Research Institute, Boston, MA
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Ross EE, Colbath RA, Yu J, Munabi N, Gillenwater TJ, Yenikomshian HA. Peer Support Groups: Identifying Disparities to Improve Participation. J Burn Care Res 2022; 43:1019-1023. [PMID: 35781574 PMCID: PMC9435488 DOI: 10.1093/jbcr/irac086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Disparities in psychosocial outcomes after burn injury exist in patients from racial or ethnic minority groups in the United States. Peer support groups can help patients with many psychosocial aspects of recovery from burns; however, access to such support among patients of racial and ethnic minority or low socioeconomic groups are unknown. The present study examined participation rates in outpatient peer support within this patient population. Patients attending outpatient clinic at an urban safety-net hospital and regional burn center with a majority minority patient population were asked about participation in burn survivor group, interest in joining a group, and given validated survey questions about managing emotions and social interactions since injury. Current or past participation in peer support was low (4.2%), and 30.3% of patients not already in support group were interested in joining. Interest in future participation in peer support was highest among Hispanic patients (37.0%) and lowest among Black patients (0%). Logistic regression models demonstrated that increased total body surface area burned, hospital length of stay, and need for surgical intervention were associated with interest in joining or having joined a peer support group. Effectiveness of management of emotions and social interactions were not associated with interest in joining peer support in the future. These findings demonstrate a considerable difference between levels of interest and participation in peer support within this population. Improving access to and education about benefits of peer support in underresourced communities may help to address the variation in psychosocial outcomes of patients across racial or ethnic minority groups recovering from burns.
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Affiliation(s)
- Erin E Ross
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Rachel A Colbath
- From the Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Jeremy Yu
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Naikhoba Munabi
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - T Justin Gillenwater
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
| | - Haig A Yenikomshian
- Division of Plastic Surgery, Keck School of Medicine, University of SouthernCalifornia, Los Angeles, CA, USA
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Wasilewski MB, Rios J, Simpson R, Hitzig SL, Gotlib Conn L, MacKay C, Mayo AL, Robinson LR. Peer support for traumatic injury survivors: a scoping review. Disabil Rehabil 2022:1-34. [PMID: 35680385 DOI: 10.1080/09638288.2022.2083702] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Peers are uniquely able to draw on their lived experiences to support trauma survivors' recovery. By understanding the functions and outcomes of peer support and the factors that impact implementation, evidence can be mobilized to enhance its application and uptake into standard practice. As such, we aimed to review the literature on peer support for trauma survivors to: examine the role of peer support in recovery; describe the nature and extent of peer support; Examine the influence of peer support on health and well-being; and identify the barriers and facilitators to developing and implementing peer support. METHODS Scoping review methodology as outlined by Arksey and O'Malley. RESULTS Ninety-three articles were reviewed. Peer support was highlighted as an important component of care for trauma survivors and provided hope and guidance for the future post-injury. Most peer support programs were offered in the community and provided one-on-one support from peer mentors using various modalities. Interventions were successful when they involved knowledgeable peer mentors and maintained participant engagement. Prior negative experiences and stigma/privacy concerns deterred trauma survivors from participating. CONCLUSIONS Peer support fulfills several functions throughout trauma survivors' recovery that may not otherwise be met within existing health care systems. Implications for rehabilitationBy understanding the functions and outcomes and the factors that impact implementation of peer support, evidence can be mobilized to enhance its application and uptake into standard practice.Peers provide trauma survivors with socioemotional support as well as assistance in daily management and life navigation post-injury.Peer support provided hope and guidance for the future after injury and improved self-efficacy amongst trauma survivors.Peer support programs are most likely to be successful when they involve knowledgeable peer mentors, are flexibly delivered, align with organizations' values and priorities, and have adequate resources and funding to support their implementation.
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Affiliation(s)
- Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jorge Rios
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Robert Simpson
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gotlib Conn
- Tory Trauma Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, Ontario, Canada.,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Physical Medicine and Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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8
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Are burns a chronic condition? Examining patient reported outcomes up to 20 years after burn injury-A Burn Model System National Database investigation. J Trauma Acute Care Surg 2022; 92:1066-1074. [PMID: 35081598 PMCID: PMC9133040 DOI: 10.1097/ta.0000000000003547] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND People living with burn injury often face long-term physical and psychological sequelae associated with their injuries. Few studies have examined the impacts of burn injuries on long-term health and function, life satisfaction, and community integration beyond 5 years postinjury. The purpose of this study was to examine these outcomes up to 20 years after burn injury. METHODS Data from the Burn Model System National Longitudinal Database (1993-2020) were analyzed. Patient-reported outcome measures were collected at discharge (preinjury status recall) and 5 years, 10 years, 15 years, and 20 years after injury. Outcomes examined were the SF-12/VR-12 Physical Component Summary and Mental Component Summary, Satisfaction with Life Scale, and Community Integration Questionnaire. Trajectories were developed using linear mixed models with repeated measures of outcome scores over time, controlling for demographic and clinical variables. RESULTS The study population included 421 adult burn survivors with a mean age of 42.4 years. Lower Physical Component Summary scores (worse health) were associated with longer length of hospital stay, older age at injury and greater time since injury. Similarly, lower Mental Component Summary scores were associated with longer length of hospital stay, female sex, and greater time since injury. Satisfaction with Life Scale scores decrease negatively over time. Lower Community Integration Questionnaire scores were associated with burn size and Hispanic/Latino ethnicity. CONCLUSION Burn survivors' physical and mental health and satisfaction with life worsened over time up to 20 years after injury. Results strongly suggest that future studies should focus on long-term follow-up where clinical interventions may be necessary. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.
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Kamminga NCW, van der Veldt AAM, Joosen MCW, de Joode K, Joosse A, Grünhagen DJ, Nijsten TEC, Wakkee M, Lugtenberg M. Experiences of resuming life after immunotherapy and associated survivorship care needs: a qualitative study among patients with metastatic melanoma. Br J Dermatol 2022; 187:381-391. [PMID: 35596713 PMCID: PMC9545549 DOI: 10.1111/bjd.21670] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/30/2022]
Abstract
Background Immune checkpoint inhibitors (ICIs) have significantly improved the overall survival of patients with metastatic melanoma. It is unclear how the growing group of metastatic melanoma survivors resume their lives after treatment, and which needs they have regarding survivorship care (SSC). Objectives To gain an in‐depth understanding of metastatic melanoma survivors’ experiences of resuming life after ICIs and their associated SSC needs. Methods A qualitative study was conducted among 20 patients with metastatic melanoma in whom ICIs had been discontinued after ongoing tumour response. One focus group (n = 9) was held, which was complemented by 11 individual interviews. Purposive sampling was used to select a variable sample in terms of sex, age, time since discontinuation of ICIs, and perceived impact of the disease. A topic guide was used to structure the (group) interviews, which were transcribed verbatim and analysed in a thematic content analysis, using several phases of coding. Results In resuming life after ICIs, the prognosis switch often caused mixed feelings among patients, mainly because of the uncertainty about the future. Demands and expectations from self and others, persistent complaints and new problems in different life domains often make it challenging to proceed with life as it was prior to metastatic cancer. Patients indicated they needed to find a new balance, which included learning to cope with uncertainty and a changed perspective on life and close relationships. In terms of SSC needs, patients particularly stressed the need for more tailored patient information, available at one location. In addition, they emphasized the need to know who to turn to in case of questions and indicated the need for psychosocial support, also for their close relatives. Conclusions Metastatic melanoma survivors face various challenges in resuming life after ICIs and are left with several unmet SSC needs. Efforts should be focused on offering psychosocial supportive care in addition to medical care, from diagnosis onwards, taking into account the patient’s close relatives. A single point of contact and personalized survivorship care plan (SCP) could be of added value in guiding them through the patient journey, which is, given its multidisciplinary nature, particularly important in melanoma care. What is already known about this topic?Since the introduction of immune checkpoint inhibitors (ICIs) the overall survival of patients with metastatic melanoma has improved significantly, leading to a growing group of melanoma survivors. Melanoma survivors may face various problems and challenges in resuming life after treatment, which may be associated with unmet survivorship care (SSC) needs. An in‐depth understanding of their experiences with resuming life and the associated SSC needs is currently lacking.
What does this study add?Metastatic melanoma survivors experience various challenges after immunotherapy, from the uncertain prognosis switch to the struggle of finding a new balance in life. Besides negative aspects, such as complaints in different life domains, the patient journey is often accompanied by positive outcomes, for example a changed perspective on life. They stress the need for tailored patient information and broader supportive care, also for their close relatives.
What are the clinical implications of this work?In addition to medical care, efforts should be focused on offering psychosocial supportive care, including return‐to‐work issues, from diagnosis onwards, ideally taking into account the patient’s close relatives. To guide them through the patient journey, a single point of contact and a personalized survivorship care plan (SCP) could be of added value. The latter is particularly important in melanoma care, given its multidisciplinary nature.
With this qualitative study we provided an in‐depth understanding of metastatic melanoma survivors' experiences of resuming life after ICIs and their associated SSC needs. They face various challenges in resuming life and efforts should be focused on offering psychosocial supportive care, in addition to medical care, from diagnosis onwards, taking into account the patient's close relatives. A single point of contact and personalized survivorship care plan (SCP) could be of added value in guiding them through the patiënt journey which is, given its multidisciplinary nature, particularly important in melanoma care. Linked Comment:E.N. Clarke. Br J Dermatol 2022; 187:286–287.
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Affiliation(s)
- Nadia C W Kamminga
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Astrid A M van der Veldt
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Margot C W Joosen
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Karlijn de Joode
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Arjen Joosse
- Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Dirk J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Marjolein Lugtenberg
- Department of Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands.,Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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10
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Wang BB, Patel KF, Wolfe AE, Wiechman S, McMullen K, Gibran NS, Kowalske K, Meyer WJ, Kazis LE, Ryan CM, Schneider JC. Adolescents with and without head and neck burns: comparison of long-term outcomes in the burn model system national database. Burns 2022; 48:40-50. [PMID: 33975762 PMCID: PMC8526620 DOI: 10.1016/j.burns.2021.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/16/2021] [Accepted: 04/12/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Facial burns account for persistent differences in psychosocial functioning in adult burn survivors. Although adolescent burn survivors experience myriad chronic sequelae, little is known about the effect of facial injuries. This study examines differences in long-term outcomes with and without head and neck involvement. METHODS Data collected for 392 burn survivors between 14-17.9 years of age from the Burn Model System National Database (2006-2015) were analyzed. Comparisons were made between two groups based on presence of a head and neck burn (H&N) using the following patient reported outcome measures: Satisfaction with Appearance Scale, Satisfaction with Life Scale, Community Integration Questionnaire, and Short Form-12 Health Survey at 6, 12, and 24 months after injury. Regression analyses were used to assess association between outcome measures and H&N group at 12-months. RESULTS The H&N group had more extensive burns, had longer hospital stays, were more likely to be burned by fire/flame and were more likely to be Hispanic compared to the non-H&N group. Regression analysis found that H&N burn status was associated with worse SWAP scores. No significant associations were found between H&N burn status and other outcome measures. CONCLUSIONS Adolescents with H&N burn status showed significantly worse satisfaction with appearance at 12-months after injury. Future research should examine interventions to help improve body image and coping for adolescent burn survivors with head and neck burns.
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Affiliation(s)
| | - Khushbu F. Patel
- Shriners Hospitals for Children – Boston, Boston, MA United States,Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Audrey E. Wolfe
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, United States
| | - Shelley Wiechman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Nicole S. Gibran
- Department of Surgery, University of Washington Harborview, Seattle, WA, United States
| | - Karen Kowalske
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Walter J. Meyer
- Department of Psychiatry, University of Texas Medical Branch, Galveston, TX, United States
| | - Lewis E. Kazis
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, United States
| | - Colleen M. Ryan
- Shriners Hospitals for Children – Boston, Boston, MA United States,Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Jeffrey C. Schneider
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Charlestown, MA, United States,Corresponding author. (J.C. Schneider)
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11
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Grant E, Johnson L, Prodromidis A, Giannoudis PV. The Impact of Peer Support on Patient Outcomes in Adults With Physical Health Conditions: A Scoping Review. Cureus 2021; 13:e17442. [PMID: 34589348 PMCID: PMC8462539 DOI: 10.7759/cureus.17442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
Little is known about the impact of peer support programmes on physical health populations or on the methods used to evaluate such programmes. The present study undertakes a scoping review of research related to peer support programmes or interventions in physical health populations, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). The search was carried out across the Medline, PsycINFO, and Cochrane databases and focused on papers that evaluated peer support intervention(s) in adults with physical health conditions. The search identified an initial 7,903 records, which were narrowed down to 21 records that met the inclusion criteria; their findings were narratively synthesized. The scoping review found considerable heterogeneity among eligible records in terms of their study design, outcome measurements and findings reported. Qualitative methods of evaluation generated more consistent findings compared to objective outcome measures and suggested that peer support was beneficial for patients’ health and wellbeing by reducing feelings of isolation and creating a sense of community as well as providing an opportunity for information consolidation. The scoping review highlights the inconsistencies in methods used to evaluate peer support interventions and programmes in healthcare settings among different physical health populations. It also draws attention to the lack of peer support research in particular areas, including in acute physical health populations such as in major trauma. The scoping review emphasizes the need for future studies to address this gap in peer support research.
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Affiliation(s)
- Ellie Grant
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | - Louise Johnson
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR
| | | | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, University of Leeds, Leeds, GBR
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12
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Hemmati Maslakpak M, Ajoudani F, Lotfi M, Alinejad V. Society, family, and individual characteristics as double-edged swords in the social reintegration of Iranian female survivors from unintentional severe burns: a qualitative study of enablers and barriers. BMC WOMENS HEALTH 2021; 21:339. [PMID: 34560875 PMCID: PMC8464107 DOI: 10.1186/s12905-021-01481-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/16/2021] [Indexed: 11/24/2022]
Abstract
Background Reintegrating to society is a significant challenge during burn survivors’ rehabilitation. Aim This study aims to describe what Iranian female survivors from unintentional severe burns experience as enablers and barriers of social reintegration (SR). Methods Fourteen adult female burn survivors whose burns were unintentional participated in this qualitative study. Data were gathered through semi-structured face-to-face or telephone interviews and analyzed using inductive content analysis. Results Thirteen subcategories and six categories were emerged. Categories and subcategories of enablers content area were as follows: positive impact of society on SR (normal treatment of society, instrumental support), positive impact of family on SR (magnifying personal abilities assets, empathy and emotional support), and positive impact of personal characteristics on SR (coping with others stares, right to have a normal social life). Categories and subcategories of Barriers content area were as follows: negative impact of society on SR (being questioned in public, incorrect judgment about intent of burns, burns as a contagious disease), negative impact of family on SR (embarrassment of appearing in public with the survivor, family mistrust), and negative impact of intra-personal factors on SR (exaggeration of the post-burn changes, being over-sensitive to the others looks). From the deep interpretation of the data two overarching themes were emerged: “acceptance of the new normal by the society and the individual” and “being encompassed by misconceptions and mistreatments”.
Conclusions Society, family and the individual characteristics have a dual role to play in the success of social reintegration in Iranian female unintentional burn survivors.
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Affiliation(s)
| | - Fardin Ajoudani
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
| | - Mojgan Lotfi
- Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Alinejad
- Patient Safety Research Centre, Urmia University of Medical Sciences, Urmia, Iran
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13
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Carrougher GJ, McMullen K, Amtmann D, Wolfe AE, Tenney D, Schneider JC, Yeakley J, Holavanahalli RK, Patterson L, Madison C, Gibran NS. "Living Well" After Burn Injury: Using Case Reports to Illustrate Significant Contributions From the Burn Model System Research Program. J Burn Care Res 2021; 42:398-407. [PMID: 32971531 PMCID: PMC10044562 DOI: 10.1093/jbcr/iraa161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The Burn Model System (BMS) program of research has been funded since 1993 by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The overarching aim of this program is to improve outcomes and quality of life for people with burns in the areas of health and function, employment, and community living and participation. This review reports on BMS contributions that have affected the lives of individuals with a significant burn injury using case reports to associate BMS contributions with recovery. In January 2020, current BMS grantee researchers assessed peer-reviewed BMS publications from 1994 to 2020. Using case report methodology, contributions were linked to three individuals treated at one of the four Burn Model System institutions. With over 25 years of NIDILRR funding, unique BMS contributions to patient recovery were identified and categorized into one of several domains: treatment, assessment measures, sequelae, peer support, employment, and long-term functional outcomes. A second review for significant results of BMS research that add to the understanding of burn injury, pathophysiology, and recovery research was identified and categorized as injury recovery research. The case study participants featured in this review identified select NIDILRR research contributions as having direct, personal benefit to their recovery. The knowledge generation and clinical innovation that this research program has contributed to our collective understanding of recovery after burn injury is considerable. Using case study methodology with three adult burn survivors, we highlight the impact and individual significance of program findings and reinforce the recognition that the value of any clinical research must have relevance to the lives of the study population.
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Affiliation(s)
| | - Kara McMullen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Audrey E Wolfe
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Loren Patterson
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Nicole S Gibran
- Department of Surgery, University of Washington, Seattle, Washington
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14
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Spronk I, Van Loey NEE, van der Vlies CH, Haagsma JA, Polinder S, van Baar ME. Activity impairment, work status, and work productivity loss in adults 5-7 years after burn injuries. J Burn Care Res 2021; 43:256-262. [PMID: 33693704 PMCID: PMC8737115 DOI: 10.1093/jbcr/irab047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
An important aspect of the rehabilitation of burn patients is social participation, including daily activities and work. Detailed information on long-term activity impairment and employment is scarce. Therefore, we investigated activity impairment, work status, and work productivity loss in adults 5–7 years following burn injuries, and investigated associations with burn-specific health-related quality of life (HRQL) domains. Adult participants completed the Work Productivity and Activity Impairment General Health questionnaire and the Burn Specific Health Scale-brief (BSHS-B) 5–7 years post-burn. Outcomes were compared between participants with mild/intermediate and severe burns (>20% total body surface area burned). Seventy-six (36%) of the 213 participants experienced some degree of activity impairment due to burn-related problems 5–7 years post-burn. Seventy percent of the population was employed; 12% of them experienced work productivity loss due to burn-related problems. Nineteen percent reported changes in their work situation (partly) because of the burn injury. A higher proportion of participants with severe burns had activity impairments (56% vs 29%; P = .001) and work productivity loss (26% vs 8%; P < .001) compared to participants with mild/intermediate burns. Activity impairment and work productivity loss were both associated with burn-related work problems and lower mood, measured with the BSHS-B. In conclusion, a substantial part of the study population experienced activity impairment and work productivity loss, was unemployed, and/or reported changes in their work situation due to their injury. Particularly patients with severe burns reported productivity loss and had lower employment rates. This subscribes the importance of addressing work-related functioning in the rehabilitation of burn patients.
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Affiliation(s)
- Inge Spronk
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands.,Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Nancy E E Van Loey
- Association of Dutch Burn Centres, Department Behavioural Research, Beverwijk, the Netherlands.,Utrecht University, Department Clinical Psychology, Utrecht, the Netherlands
| | - Cornelis H van der Vlies
- Burn Centre, Maasstad Hospital, Rotterdam, the Netherlands.,Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Suzanne Polinder
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
| | - Margriet E van Baar
- Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, the Netherlands.,Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands
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15
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Won P, Bello MS, Stoycos SA, Carrera BT, Kurakazu DM, Briere J, Garner WL, Gillenwater J, Yenikomshian HA. The Impact of Peer Support Group Programs on Psychosocial Outcomes for Burn Survivors and Caregivers: A Review of the Literature. J Burn Care Res 2021; 42:600-609. [PMID: 33677491 DOI: 10.1093/jbcr/irab042] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Peer support group programs are often recommended for burn survivors as a way to facilitate their psychosocial recovery and reintegration into the community. Such programs provide opportunities for burn patients and their caretakers to access emotional and informational support from healthcare providers and other survivors in inpatient or outpatient settings. Despite their popularity, however, there is little information currently available on the efficacy of these groups. In response, we reviewed the existing literature on peer support group programs and their impacts on psychosocial outcomes for burn survivors and their caregivers. A systematic review of the literature utilizing PubMed, PsycINFO, and Medline databases was conducted for articles published between 1990 and 2018. Twenty-five articles including inpatient, outpatient, integrative peer support groups, and burn camps met our inclusion criteria. All inpatient peer support group program articles (n = 4) reported associations with psychosocial improvements. Integrative peer support group program articles (n = 2) reported associations with social integration and reduction in post-traumatic stress and anxiety. All outpatient peer support group program articles (n = 8) demonstrated associations with psychosocial outcomes involving life satisfaction, acceptance of self, and reduced levels of isolation. Findings were less consistent for burn camps: eight articles suggested improvements in psychological outcomes while three articles reported no significant psychosocial effects. Although these results are encouraging, further study is indicated both to replicate these findings, and to determine the optimal implementation of inpatient and outpatient peer support programs.
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Affiliation(s)
- Paul Won
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mariel S Bello
- LAC+USC Hospital, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Sarah A Stoycos
- LAC+USC Hospital, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Brenda T Carrera
- LAC+USC Hospital, University of Southern California, Los Angeles, CA, USA
| | - Dawn M Kurakazu
- LAC+USC Hospital, University of Southern California, Los Angeles, CA, USA
| | - John Briere
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Warren L Garner
- Division of Plastic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Justin Gillenwater
- Division of Plastic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Haig A Yenikomshian
- Division of Plastic Surgery, University of Southern California, Los Angeles, CA, USA
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16
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Aghakhani N, Lopez V, Parizad N, Baghaei R. "It was like nobody cared about what I said?" Iranian women committed self-immolation: a qualitative study. BMC Womens Health 2021; 21:75. [PMID: 33607973 PMCID: PMC7893762 DOI: 10.1186/s12905-021-01221-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Suicide-attempts have increased across the world and have become higher among females. There has been a high prevalence of self-immolation in Iran, mostly young married women admitted to the burn centers. This study aimed to explore the factors and experiences of self-immolation in Iranian married women to develop prevention strategies to prevent the personal, social, and economic impacts of suicide and suicide attempts. METHODS A qualitative descriptive approach using open-ended, in-depth, face-to-face interviews was conducted in a purposive sample of 16 married Iranian women aged 16-40 years in the burn centers in Urmia city, a place in northwest Iran. Conventional content analysis was used to analyze the data. RESULTS Three themes emerged from the data, including (1) antecedents of self-immolation, (2) suicidal ideation method, and (3) pathway to recovery. Each of these themes is supported by sub-themes. CONCLUSIONS The study highlights the demand for health professionals to support self-immolation survivors to continue their normal lives. According to survivors' needs, a comprehensive supportive program is recommended to support their pathways to recovery in all its complexities. Health professionals should also not forget that the survivors' family also will need help to overcome this trauma. A family counseling program may also be provided.
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Affiliation(s)
- Nader Aghakhani
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, China
- School of Nursing, University of Tasmania, Hobart, Australia
| | - Naser Parizad
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
| | - Rahim Baghaei
- Patient Safety Research Center, Clinical Research Institute, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Campus Nazlu, 11 KM Road Seru, 575611-5111 Urmia, West Azerbaijan Iran
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17
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Slavin MD, Ryan CM, Schneider JC, Acton A, Amaya F, Saret C, Ohrtman E, Wolfe A, Ni P, Kazis LE. Interpreting Life Impact Burn Recovery Evaluation Profile Scores for Use by Clinicians, Burn Survivors, and Researchers. J Burn Care Res 2021; 42:23-31. [PMID: 32556266 PMCID: PMC8265741 DOI: 10.1093/jbcr/iraa100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The Life Impact Burn Recovery Evaluation (LIBRE) Profile is a patient-reported outcome measure developed to assess social participation in adult burn survivors. This study identified numeric score cut-points that define different levels of social participation ability and described each level. An expert panel identified numeric score cut-points that distinguish different levels of social participation for the six LIBRE Profile domains. Methods employed an iterative, modified-Delphi approach, and bookmarking to review calibrated item banks. Analyses (using calibration sample data and repeated in a validation sample) examined means, SDs, and sample distributions for each level. Analyses of variance examined score differences between levels. The panel developed descriptions for each established level. Initial cut-points resulted in four levels for five domains (Social Activities, Social Interactions, Romantic Relationships, Sexual Relationships, and Work & Employment) and five levels for the sixth domain (Relationships with Family & Friends). Comparisons demonstrated significant differences between level mean scores for all domains (P < .05) except Relationships with Family & Friends. Based on follow-up surveys, Relationships with Family & Friends score cut-points were adjusted to identify four levels with significant score differences between all levels. Panelists reached consensus for level descriptions. Score cut-points and descriptions identify different levels of social participation, providing a relevant context for interpreting LIBRE Profile numeric scores. LIBRE Profile Social Participation levels will help clinicians and persons with burn injury interpret LIBRE Profile numeric scores and promote use of this important new assessment.
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Affiliation(s)
- Mary D. Slavin
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Colleen M. Ryan
- Sumner Redstone Burn Center, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston®
| | - Jeffrey C. Schneider
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
- Spaulding Research Institute, Boston, Massachusetts
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Flor Amaya
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Cayla Saret
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Emily Ohrtman
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Audrey Wolfe
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Pengsheng Ni
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
| | - Lewis E. Kazis
- Boston University School of Public Health, Department of Health Law, Policy and Management, Boston, Massachusetts, Massachusetts
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18
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Ong JE, Fassel M, Scieszinski L, Hosseini S, Galet C, Oral R, Wibbenmeyer L. The burden of adverse childhood experiences in children and those of their parents in a burn population. J Burn Care Res 2021; 42:944-952. [PMID: 33484246 DOI: 10.1093/jbcr/irab009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the prevalence, type, and associations of parental and child adverse childhood experiences (ACEs) in children presenting with burn injuries. METHODS Parents of burned children completed an ACE-18 survey, including questions on parent and child ACEs, needs, and resiliency. Demographics, burn injury, hospital course, and follow up data were collected. Family needs and burn outcomes of children with and without ACEs' exposure (NO ACE vs. 1-2 ACE vs ≥ 3 ACE) was analyzed. P < 0.05 was considered significant. RESULTS Seventy-five children were enrolled; 58.7% were male, 69.3% white. The average age was 6.0 ± 5.2 years. The average total burn surface area was 4.4 ± 5.7% (0.1 to 27%). Parent ACE exposure correlated with child ACE exposure (r = 0.57; p = 0.001) and this intensified by increasing child age (p = 0.004). Child ACE exposure showed a graded response to family needs, including food and housing insecurity and childcare needs. Stress and psychosocial distress of the parents was significantly associated with their children's ACE burden. CONCLUSIONS The ACE burden of parents of burned children can affect the ACE load of their children. Burned children with more ACEs tend to have significantly more needs and more family distress. Awareness of past trauma can help identify a vulnerable population to ensure successful burn recovery.
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Affiliation(s)
- Jia Ern Ong
- College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
| | - Mikenzy Fassel
- Carver College of Medicine, University of Iowa, Iowa City, IA
| | | | | | - Colette Galet
- Department of Surgery, University of Iowa, Iowa City, IA
| | - Resmiye Oral
- Dartmouth Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH
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19
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Cristall N, Kohja Z, Gawaziuk JP, Spiwak R, Logsetty S. Narrative discourse of burn injury and recovery on peer support websites: A qualitative analysis. Burns 2020; 47:397-401. [PMID: 33246671 DOI: 10.1016/j.burns.2020.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/28/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
Although advances have been made in burn care and recovery, less is known about the experience of living with severe burn injury. Like other patient groups, burn survivors are now turning to social media and shared web-based peer support resources during recovery and continuing long after discharge. Ongoing peer support is often part of the reclamation process after-burn injury. Peer support and event sharing helps foster hope, motivation and reassurance. OBJECTIVES To: 1) Examine and further understand the narrative discourse of burn survivorship in peer support social media content, 2) establish commonalities in the sharing community and key themes related to recovery and adaptation. METHODS This qualitative enquiry began with a comprehensive overview of burn narratives on survivor peer generated websites. We conducted a purposeful sampling of 21 biographies posted on burn survivor peer and patient support websites. Participants with greater than 30% burn injury were included that provided narrative and discourse regarding burn recovery and survivorship. Underlying story arcs, meaning behind sentences and shared language of the experience were investigated using thematic analysis. RESULTS Four themes were identified: retelling of the traumatic event; social support; body image, the new normal; and rebirth and transformation. Accounts reflected the traumatic nature of the event with slowed downtime, attention to details and heightened recall. The value of peer and family support was a common theme. There was attention to the challenges related to changed body image and regaining confidence in body appearance. Most stories also documented transitioning and rebirth and other more positive aspects of trauma recovery. CONCLUSIONS Accounting the burn experience and recovery is part of the reclamation process. Biographies document the trauma recovery process. Storying the event is an integral component of burn survivor community content. These online communities have become a mainstream resource and part of the reclamation process.
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Affiliation(s)
- Nora Cristall
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Zeenib Kohja
- College of Medicine, BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Justin P Gawaziuk
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Rae Spiwak
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarvesh Logsetty
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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20
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Ohrtman EA, Shapiro GD, Wolfe AE, Trinh NHT, Ni P, Acton A, Slavin MD, Ryan CM, Kazis LE, Schneider JC. Sexual activity and romantic relationships after burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study. Burns 2020; 46:1556-1564. [PMID: 32948357 DOI: 10.1016/j.burns.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-burn rehabilitation. The degree to which persons with burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of adult burn survivors compared to a general United States sample. METHODS Data for the adult burn survivor sample were from 601 adult burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample. RESULTS Participants were slightly more likely to report being sexually active in the adult burn survivor sample than in the general sample (65% vs. 57%, p < 0.01). There was not a significant difference in romantic relationship status between the two samples (64% vs. 62%, p = 0.31). In multivariable regression analyses, men in both samples were more likely to report being in a sexual relationship (RR in LIBRE sample = 1.23, 95% CI 1.08-1.39; RR in general sample = 1.10, 95% CI 1.02-1.18). Participants in both samples who were not working were less likely to report being sexually active or in a romantic relationship (RRs ranging from 0.73 to 0.83, p < 0.05 for all estimates). In the adult burn survivor sample, respondents with hand burns were more likely to report being sexually active and in a romantic relationship (RR = 1.16, 95% CI 1.01-1.33). Time since burn injury, burn size, and burns to other critical areas were not significantly associated with either outcome in adjusted analyses. CONCLUSIONS The likelihood of engaging in sexual activity and romantic relationships is similar among adult burn survivors and the comparison group representing a general United States sample of adults. Further research addressing sexual activity and romantic relationships after burn injuries will help to foster better patient-clinician dialogue, pinpoint barriers, design interventions, and allocate appropriate resources.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Gabriel D Shapiro
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Audrey E Wolfe
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Nhi-Ha T Trinh
- Massachusetts General Hospital, Boston, MA, United States
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA, United States
| | - Amy Acton
- The Phoenix Society for Burn Survivors, Grand Rapids, MI, United States
| | - Mary D Slavin
- Boston University School of Public Health, Boston, MA, United States
| | - Colleen M Ryan
- Massachusetts General Hospital, Boston, MA, United States; Shriners Hospital for Children - Boston, Harvard Medical School, Boston, MA, United States
| | - Lewis E Kazis
- Boston University School of Public Health, Boston, MA, United States
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
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21
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Fassel M, Grieve B, Hosseini S, Oral R, Galet C, Ryan C, Kazis L, Pengsheng N, Wibbenmeyer LA. The Impact of Adverse Childhood Experiences on Burn Outcomes in Adult Burn Patients. J Burn Care Res 2020; 40:294-301. [PMID: 30873544 DOI: 10.1093/jbcr/irz014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Adverse childhood experiences (ACEs), including child maltreatment and household dysfunction, define adverse events that occur before 18 years of age. National and state data show that between 12.5 and 14.5% of the adult population report ≥4 ACEs (HIGH-ACE), respectively. HIGH-ACEs are associated with more chronic health problems. To date, the interaction between ACEs and burn injuries has not been studied. Herein, we sought to define the ACE exposure in our burn patients and its impact on early outcomes. Inpatient and outpatient adult burn survivors (≥18 years of age) were enrolled. Subjects completed surveys assessing adverse experiences (ACEs-18), needs, strengths, and resiliency at consent, and pain, depression, post-traumatic stress disorder (PTSD), and social participation surveys at 2 weeks to 3 months postinjury. Demographics, burn, and hospital course data were also collected. Chi-square and student's t-tests were used for descriptive analysis and to compare the groups (HIGH-ACE vs LOW-ACE). The HIGH-ACE group (n = 24; 45.3%) reported more depressive symptoms (P < .04) than the LOW-ACE group (n = 29, 54.7%). HIGH-ACE patients were less resilient when facing stressful events (P ≤ .02) and more likely to screen positive for probable PTSD (P = .01) and to score lower on the Life Impact Burn Recovery Evaluation Profile (LIBRE Profile), which assesses for social participation, in the domain of Family and Friends (P = .015). Our exploratory study suggests that ACE screening may help detect burn patients at risk for a more complicated recovery, thereby promoting personalized assistance in recovery.
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Affiliation(s)
- Mikenzy Fassel
- Carver College of Medicine, University of Iowa, Iowa City
| | - Brian Grieve
- Carver College of Medicine, University of Iowa, Iowa City
| | - Sameen Hosseini
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City
| | - Resmiye Oral
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City
| | - Colette Galet
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City
| | - Colleen Ryan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School Shriners Hospitals for Children-Boston
| | - Lewis Kazis
- Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Policy and Management, Boston University School of Public Health, Massachusetts
| | - Ni Pengsheng
- Center for the Assessment of Pharmaceutical Practices (CAPP), Department of Health Policy and Management, Boston University School of Public Health, Massachusetts
| | - Lucy A Wibbenmeyer
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City
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22
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23
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Kearns RD, Bettencourt AP, Hickerson WL, Palmieri TL, Biddinger PD, Ryan CM, Jeng JC. Actionable, Revised (v.3), and Amplified American Burn Association Triage Tables for Mass Casualties: A Civilian Defense Guideline. J Burn Care Res 2020; 41:770-779. [PMID: 32298453 DOI: 10.1093/jbcr/iraa050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Burn care remains among the most complex of the time-sensitive treatment interventions in medicine today. An enormous quantity of specialized resources are required to support the critical and complex modalities needed to meet the conventional standard of care for each patient with a critical burn injury. Because of these dependencies, a sudden surge of patients with critical burn injuries requiring immediate and prolonged care following a burn mass casualty incident (BMCI) will place immense stress on healthcare system assets, including supplies, space, and an experienced workforce (staff). Therefore, careful planning to maximize the efficient mobilization and rational use of burn care resources is essential to limit morbidity and mortality following a BMCI. The U.S. burn care profession is represented by the American Burn Association (ABA). This paper has been written by clinical experts and led by the ABA to provide further clarity regarding the capacity of the American healthcare system to absorb a surge of burn-injured patients. Furthermore, this paper intends to offer responders and clinicians evidence-based tools to guide their response and care efforts to maximize burn care capabilities based on realistic assumptions when confronted with a BMCI. This effort also aims to align recommendations in part with those of the Committee on Crisis Standards of Care for the Institute of Medicine, National Academies of Sciences. Their publication guided the work in this report, identified here as "conventional, contingency, and crisis standards of care." This paper also includes an update to the burn Triage Tables- Seriously Resource-Strained Situations (v.2).
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Affiliation(s)
- Randy D Kearns
- College of Business Administration, University of New Orleans, Louisiana.,School of Medicine, University of North Carolina, Chapel Hill
| | | | - William L Hickerson
- Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis.,American Burn Association, Chicago, Illinois
| | - Tina L Palmieri
- Firefighters Burn Institute Burn Center, University of California, Davis.,Shriners Hospital for Children Northern California, Sacramento
| | - Paul D Biddinger
- Division of Emergency Preparedness, Department of Emergency Medicine, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts
| | - Colleen M Ryan
- Harvard Medical School, Boston, Massachusetts.,Department of Surgery, Massachusetts General Hospital, Boston.,Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston
| | - James C Jeng
- Shriners Hospitals for Children-Boston®, Massachusetts.,Crozer-Keystone Health System, Nathan Speare Regional Burn Treatment Center, Philadelphia, Pennsylvania
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24
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Ohrtman EA, Shapiro GD, Simko LC, Dore E, Slavin MD, Saret C, Amaya F, Lomelin-Gascon J, Ni P, Acton A, Marino M, Kazis LE, Ryan CM, Schneider JC. Social Interactions and Social Activities After Burn Injury: A Life Impact Burn Recovery Evaluation (LIBRE) Study. J Burn Care Res 2020; 39:1022-1028. [PMID: 30016442 DOI: 10.1093/jbcr/iry038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Social interactions and activities are key components of social recovery following burn injuries. The objective of this study is to determine the predictors of these areas of social recovery. This study provides a secondary analysis of a cross-sectional survey of adult burn survivors. The Life Impact Burn Recovery Evaluation-192 was administered to 601 burn survivors for the field-testing of the Life Impact Burn Recovery Evaluation Profile. Survivors aged 18 years and older with injuries ≥5% total BSA or burns to critical areas (hands, feet, face, or genitals) were eligible to participate. Multivariate linear regression analyses were used to determine predictors of the Social Activities and Social Interactions scale scores. A total of 599 people completed the Social Interactions and Social Activities scales. Of these, 77% identified as White Non-Hispanic, 55% were female, 55% were unmarried, and 80% had burns to critical areas. Participants had a mean age of 45 years, a mean time since burn injury of 15 years, and a mean burn size of 41% total BSA. Younger age (P < .01) and being married/living with a significant other (P ≤ .01) were associated with higher Social Activities and Social Interactions scale scores. Individual item responses reveal that survivors had lower scores on items related to participating in outdoor activities (30.4%) or feeling uncomfortable with their appearance (32.4% report dressing to avoid stares). Social interactions and activities are long-term challenges for burn survivors. It is important for clinicians to identify patients who may struggle with social recovery in order to focus on future community-based interventions.
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Affiliation(s)
- Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Laura C Simko
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emily Dore
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Mary D Slavin
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Cayla Saret
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Flor Amaya
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - J Lomelin-Gascon
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Pengsheng Ni
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Lewis E Kazis
- Department of Health, Law, Policy and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Massachusetts General Hospital, Shriners Hospitals for Children, Harvard Medical School, Boston
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts
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25
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Benavides L, Shie V, Yee B, Yelvington M, Simko LC, Wolfe AE, McMullen K, Epp J, Parry I, Shon R, Holavanahalli R, Herndon D, Rosenberg M, Rosenberg L, Meyer W, Gibran N, Wiechman S, Ryan CM, Schneider JC. An Examination of Follow-up Services Received by Vulnerable Burn Populations: A Burn Model System National Database Study. J Burn Care Res 2020; 41:377-383. [PMID: 31710682 DOI: 10.1093/jbcr/irz185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
While disparities in healthcare outcomes and services for vulnerable populations have been documented, the extent to which vulnerable burn populations demonstrate disparities in long-term care is relatively underexplored. This study's goal was to assess for differences in long-term occupational or physical therapy (OT/PT) and psychological service use after burn injury in vulnerable populations. Data from the Burn Model System National Database (2006-2015) were analyzed. The vulnerable group included participants in one or more of these categories: 65 years of age or older, nonwhite, no insurance or Medicaid insurance, preinjury receipt of psychological therapy or counseling, preinjury alcohol and/or drug misuse, or with a preexisting disability. Primary outcomes investigated were receipt of OT/PT and psychological services. Secondary outcomes included nine OT/PT subcategories. Outcomes were examined at 6, 12, and 24 months postinjury. One thousand one hundred thirty-six burn survivors (692 vulnerable; 444 nonvulnerable) were included. The vulnerable group was mostly female, unemployed at time of injury, and with smaller burns. Both groups received similar OT/PT and psychological services at all time points. Adjusted regression analyses found that while the groups received similar amounts services, some vulnerable subgroups received significantly more services. Participants 65 years of age or older, who received psychological therapy or counseling prior to injury, and with a preexisting disability received more OT/PT and psychological or peer support services at follow-up. Overall, vulnerable and nonvulnerable groups received comparable OT/PT and psychological services. The importance of long-term care among vulnerable subgroups of the burn population is highlighted by this study. Future work is needed to determine adequate levels of follow-up services.
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Affiliation(s)
- Lynne Benavides
- Rhode Island Burn Center, Rhode Island Hospital, Providence, Rhode Island
| | - Vivian Shie
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Brennan Yee
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Miranda Yelvington
- Department of Rehabilitation, Arkansas Children's Hospital, Little Rock, Arkansas
| | - Laura C Simko
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Audrey E Wolfe
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | | | - Janelle Epp
- Burnett Burn Center, University of Kansas Health System, Kansas City, Kansas
| | - Ingrid Parry
- University of California Davis and Shriners Hospitals for Children - Northern California; Sacramento, California
| | | | - Radha Holavanahalli
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas
| | - David Herndon
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Texas
| | - Marta Rosenberg
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Galveston, Texas
| | - Laura Rosenberg
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Texas
| | - Walter Meyer
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Texas
| | - Nicole Gibran
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Galveston, Texas
| | - Shelley Wiechman
- University of Texas Medical Branch, Shriners Hospitals for Children - Galveston, Galveston, Texas
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children - Boston, Massachusetts
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
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26
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Hornsby N, Blom L, Sengoelge M. Psychosocial Interventions Targeting Recovery in Child and Adolescent Burns: A Systematic Review. J Pediatr Psychol 2020; 45:15-33. [PMID: 31697370 DOI: 10.1093/jpepsy/jsz087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/19/2019] [Accepted: 10/02/2019] [Indexed: 02/06/2023] Open
Abstract
Children post-burn injury experience a range of psychosocial sequelae that benefit from early provision of psychosocial support. However, no systematic review exists evaluating the full range of psychological interventions. OBJECTIVE To critically evaluate psychosocial interventions for children (<18 years old) with burn injuries in improving psychosocial recovery. STUDY DESIGN All-language studies were identified from inception to March 2018 in six electronic databases and appraised according to PRISMA checklist and Cochrane Risk of Bias Tool for quality. Studies were stratified into three groups: distraction (virtual reality, child life therapy, imagery-based therapy, hypnosis), burn camps, and other (social skills, cognitive behavioral therapy, parent group counseling). RESULTS Out of a total of 5,456 articles identified, 297 underwent full review resulting in 27 included articles published between 1986 and 2018. Sample sizes ranged from 9 to 266, comprising child and adult participants. A range of interventions and psychosocial outcome measures were found. Several studies (n = 21) reported statistically significant improvements in outcome; the majority were distraction interventions to reduce pain and anxiety. A limited number of studies showing effect was found for cognitive behavioral therapy and parent counseling. Risk of bias was high in studies of burn camps and mixed for all other interventions. CONCLUSIONS A range of psychosocial interventions and outcome tools exist in pediatric burns. Distraction interventions prior to and/or during dressing changes or physical therapy were shown to effectively reduce pain and anxiety for a wide range of pediatric ages.
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Affiliation(s)
- Nancy Hornsby
- Violence, Injury and Peace Research Unit, South African Medical Research Council-UNISA
| | - Lisa Blom
- Department of Public Health Sciences, Karolinska Institutet, Global Health
| | - Mathilde Sengoelge
- Department of Public Health Sciences, Karolinska Institutet, Global Health
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27
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Holavanahalli RK, Schneider JC, Miller AC. Introduction to the NIDILRR Burn Model System (BMS) Program: Selected Findings II. Arch Phys Med Rehabil 2019; 101:S0003-9993(19)31369-3. [PMID: 31733193 DOI: 10.1016/j.apmr.2019.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/26/2022]
Abstract
A special supplement to the Archives of Physical Medicine and Rehabilitation in 2007 reported selected findings of research from the first 13 years of the BMS Centers and Database Coordinating Center. This special supplement is the second such effort and reports on the growth of the BMS National Longitudinal Database (BMS NDB) since that time and select new research findings from the BMS centers.
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Affiliation(s)
| | | | - A Cate Miller
- National Institute on Disability, Independent Living, and Rehabilitation Research, Washington, DC
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28
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Levi B, Kraft CT, Shapiro GD, Trinh NHT, Dore EC, Jeng J, Lee AF, Acton A, Marino M, Jette A, Armstrong EA, Schneider JC, Kazis LE, Ryan CM. The Associations of Gender With Social Participation of Burn Survivors: A Life Impact Burn Recovery Evaluation Profile Study. J Burn Care Res 2018; 39:915-922. [PMID: 29733365 PMCID: PMC6198731 DOI: 10.1093/jbcr/iry007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Burn injury can be debilitating and affect survivors' quality of life in a profound fashion. Burn injury may also lead to serious psychosocial challenges that have not been adequately studied and addressed. Specifically, there has been limited research into the associations of burn injury on community reintegration based on gender. This work analyzed data from 601 burn survivors who completed field testing of a new measure of social participation for burn survivors, the Life Impact Burn Recovery Evaluation (LIBRE) Profile. Differences in item responses between men and women were examined. Scores on the six LIBRE Profile scales were then compared between men and women using analysis of variance and adjusted linear multivariate regression modeling. Overall, men scored significantly better than women on four of the six LIBRE Profile scales: Sexual Relationships, Social Interactions, Work & Employment, and Romantic Relationships. Differences were not substantially reduced after adjustment for demographic characteristics and burn size. Men scored better than women in most of the areas measured by the LIBRE Profile. These gender differences are potentially important for managing burn patients during the post-injury recovery period.
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Affiliation(s)
- Benjamin Levi
- Division of Plastic Surgery, University of Michigan, Ann Arbor
| | - Casey T Kraft
- Department of Plastic Surgery, Ohio State University, Columbus
| | - Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University Montreal, Quebec, Canada
| | - Nhi-Ha T Trinh
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Emily C Dore
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - James Jeng
- Mount Sinai Healthcare System, New York, New York
| | - Austin F Lee
- Department of Surgery, Massachusetts General Hospital, Boston
- School of Insurance and Economics, University of International Business and Economics, Beijing, China
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts
| | - Amy Acton
- Phoenix Society for Burn Survivors, Grand Rapids, Michigan
| | - Molly Marino
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Alan Jette
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | | | - Jeffrey C Schneider
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Massachusetts
| | - Colleen M Ryan
- Department of Surgery, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, Harvard Medical School, Shriners Hospitals for Children-Boston
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